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The Business End and the Science End

Enough depression for now. The last couple of posts have not been cheerful, because there’s a lot of not-so-cheerful stuff out there in the business side of the industry. But I wanted to remind everyone (and myself) that we’re actually getting some good things done around here. Take a look at oncology – it’s starting to look like this could be the era when people, decades from now, will say that the corner was turned. Some of the results coming out of recent trials have been really eye-opening, both the small molecules and the biologics. And the recent focus on immune-based therapies has shown a lot of dramatic progress (which is also attracting a lot of dramatic investment money). We’re just barely starting on these things, and on the combinations that need to be tried. Real progress is really being made.
That’s just one therapeutic area, although it’s a big one. There are others advancing as well. That’s the frustrating part, in a way – coming into this field de novo, you’d look around and see so many opportunities that you wouldn’t know where to start. But many of the existing businesses (and in some cases, existing business models) are having a heck of a time fitting in. Running an organization the size of a Merck or a Pfizer, with those expenses and those legacy commitments and that overhead, really is a beastly job. But no business is owed some sort of right to always exist in its present form. Business-wise, this is an ugly period. Scientifically, it’s really quite good. Bridging those two, now – that’s where all the clanging noises are coming from.

16 comments on “The Business End and the Science End”

  1. Anonymous says:

    One of the few positive blogs. And yet no link to any positive news. 🙁

  2. Anonymous says:

    How about another Things I Won’t Work With or a How Not To Do It to lighten up the mood?

  3. Larry says:

    One way to ensure a consistent positive tone would be to write about an approval each time it happens. There have been many over the past years, and you have commented on this from the standpoint of trends, but why not spend a post on a drug that is approved as it is approved. Some write-up of the past several months would be appropriate. If this blog is about the drug industry, writing about ultimate success is important.

  4. steve says:

    Yes, the science side is going well but take a look at how it evolved. CAR-T and checkpoint inhibitors both came from academics. There’s not a large pharma on earth that would have developed those technologies early on. Not to get too tied up in the earlier thread but the MBAs would have said it’s too risky (or they would have fired the R&D staff before they could complete the work). These modalities only became hot stuff once the academics and some small, plucky biotechs took it all the way and got clinical POC. See, for example, http://www.sfgate.com/health/article/Jim-Allison-confronts-cancer-critics-with-5405290.php

  5. drug_hunter says:

    I really like Larry’s suggestion to highlight each new approval.

  6. Larry says:

    @4 makes a nice point. A focus on stories of success and how they came about can provide more insight than broad (and often negative) generalizations about drug discovery. A focus on Jim Allison, his life, his approach, his idiosyncrasies, his contributions would be much more useful than perpetuating the debate of “who discovers drugs…academics or pharma”. We don’t hear these stories enough. We don’t hear about approvals and the context of their potential impact enough. This is the pipeline, and should be a core aspect of posts, in my opinion.

  7. anon2 says:

    @6, while I agree that hearing about his story is great, he will likely not get credit beyond the people in his field.
    Jim is a PhD and the people who will get the credit are going to be MDs, likely those involved with Juno or UPenn-Novartis (not sure the name of the company here).
    Also at MD Anderson is the medical doctor Laurence Cooper. This guy took the Sleeping Beauty system invented by Perry Hackett, and just drove his postdocs and grad students into the ground further refining the system for human work. This resulted in the biggest upfront payment (or at least the biggest I have heard) of 100 million in stock to the institution. Cooper was the hero…there was absolutely no mention of the [PhD] guys who actually did the work in the lab. Cooper’s contribution was merely administrative, nor was there much press for Hackett…the guy that invented the whole thing.
    The MDs are going to be the face of these immunotherapies even though they barely understand the concept of transcription. Which is VERY unfortunately for Jim Allison, Perry Hackett, AND Zelig Eshhar.

  8. Larry says:

    @7–much appreciated insights. I do not accept that Jim or Perry or Zelig or anyone else making important contributions to drug discovery will not be recognized. This will be so only if we don’t talk about it. My point is that “In the Pipeline” should be one place where such stories are loudly and proudly told. Such efforts are important for the science and the business, the subject of DL’s original post here.

  9. steve says:

    #7, you’re mixing up two things. Jim Allison developed checkpoint inhibitors, and he is likely to get a Noble prize for it. Carl and Laurence worked on CAR-T cells so they’re not stealing any limelight from Allison. Laurence gives Perry credit all the time but Laurence is the one who developed the T cell therapy. Sure he used Perry’s transposon system but that’s like saying that Edison doesn’t deserve credit for the light bulb because he didn’t invent electricity.

  10. steve says:

    BTW, it might also be noted that Allison, the PhD, is a lot more famous than Wolchok, the MD who ran the initial clinical trial. It’s Allison who gets interviewed by the NY Times, who got recruited to head up a department at MDACC with a $10MM CPRIT grant, etc.

  11. steve says:

    On the other hand, for those who don’t think the system is rigged:
    http://www.vox.com/2015/3/11/8193321/wall-street-bonuses-2014

  12. @4 “Not to get too tied up in the earlier thread but the MBAs would have said it’s too risky”
    Not sure that’s true. Look at Lily and the numerous Alzheimer’s disease failures. I would argue they took too much risk there.

  13. anon2 says:

    @9
    My comment wasn’t comparing Cooper to Allison. It was giving examples of MDs coming in off the bench when the ball is on the one yard line and scoring in the Superbowl. There is no credit given to the rest of the team that got them into the Superbowl or pushed the ball all the way up the field. Not to insult these guys (I honestly don’t have it out for any of them, they are polite individuals) but [given the same tools] almost any immunologist MD could do what they did. There is nothing creative about what they have brought to the table…just a population of willing patients.

  14. steve says:

    I beg to differ. Carl June IS an immunologist and a very well respected one at that. He spent years and years optimizing the system, looking at which CD3 modules to add to the TCR, how to grow the cells (together with Bruce, who also made major contributions). That said, it is not trivial to bring these therapies to the clinic or run the clinical trials as there are potentially lethal side effects (cytokine storm, etc.). Laurence, who is also a physician-scientist, not just a pediatric hematologist, had the insight to apply the sleeping beauty transposon to the development of CAR-T. He also spent years developing the system. Sure there were scientists under them who did the work but it’s like any other lab head – they set the direction, provided the guidance and ultimately reaped the benefit. Neither of them from what I can see (and I don’t work with either directly) has been a glory hog and have more than adequately given credit where it’s due.

  15. steve says:

    It’s not my intention to try and dominate this thread but I wanted to share the single best article I’ve read about why the business side of pharma (and US business in general) is in such a dire state. It’s not just the “suits” it’s the recent switch in the basic idea of how you’re supposed to run a business. If you can’t access it, try Googling some of Harold Myerson’s columns.
    http://www.washingtonpost.com/opinions/why-salaries-dont-rise/2015/03/11/38c08cea-c81d-11e4-b2a1-bed1aaea2816_story.html

  16. anon2 says:

    @15 steve, I respectfully disagree about them having original contributions.
    However, this is why dialog is good in the semi-anonymous fashion here. We could be the President of an academic institution, biotech VP, or just some kid with a chemistry set.

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